Form 450 General Assignment

NRC FORM 450

U.S. NUCLEAR REGULATORY COMMISSION

(M-YYYY)

APPROVED BY OMB: NO. 3150-0114

EXPIRES: MM/DD/YYYY

Estimated burden per response to comply with this mandatory information
collection request: 2 hours. NRC requires this information to secure all rights,
titles, and interest to refunds arising out of the contract performance. Send
comments regarding burden estimate to the Records and FOIA\Privacy
Services Branch (T-5 F53), U.S. Nuclear Regulatory Commission, Washington,
DC 20555-0001, or by internet e-mail to [email protected], and to the Desk
Officer, Office of Information and Regulatory Affairs, NEOB-10202,
(3150-0114), Office of Management and Budget, Washington, DC 20503. If
a means used to impose an information collection does not display a currently
valid OMB control number, the NRC may not conduct or sponsor, and a person
is not required to respond to, the information collection.

GENERAL ASSIGNMENT

Pursuant to the terms of contract number

and in consideration of the reimbursement of costs and payment of fee, as

provided in the said contract and any assignment thereunder, (Contractor)

,

with its principal place of business at

, does hereby:

1. Assign, transfer, set over, and release to the UNITED STATES OF AMERICA (hereinafter called the Government), all rights, title and
interest to all refunds, rebates, credits, or other amounts (including any interest thereon) arising out of the performance of said contract,
together with all the rights of action accrued or which may hereafter accrue thereunder.
2. Agree to take whatever action may be necessary to effect prompt collection of all refunds, rebates, credits, or other amounts (including any
interest thereon) due or which may become due, and to promptly forward to the Contracting Officer checks made payable to the Treasurer
of the United States for any proceeds so collected. The reasonable costs of any such action to effect collection shall constitute allowable
costs when approved by the Contracting Officer as stated in the said contract and may be applied to reduce any amounts otherwise
payable to the Government under the terms thereof.
3. Agree to cooperate fully with the Government as to any claim or suit in connection with refunds, rebates, credits or other amounts due
(including any interest thereon); to execute any protest, pleading, application, power of attorney, or other papers in connection therewith;
and to permit the Government to represent it at any hearing, trial, or other proceeding arising out of such claim or suit.

IN WITNESS WHEREOF, this assignment has been executed this

day of

, 20

CONTRACTOR

BY

TITLE

CERTIFICATION

I,

, certify that I am the
,

of the corporation named as Contractor in the foregoing assignment; that
who signed said assignment on behalf of the Contractor was then the (Officer)
of said corporation; that said assignment was duly signed for and on behalf of said corporation by authority of its government body and is within the
scope of its corporate powers.

(Corporate Seal)

NRC FORM 450 (M-YYYY)

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